Abstract:

Objective To search，evaluate and summarize the best evidence of prolonging the life length of arteriovenous fistula（AVF），in order to provide a basis for medical staff to standardize the management of AVF. Methods The relevant evidence of prolonging the life length of AVF was systematically searched from domestic and foreign databases.The retrieval time is from the database construction to June 1，2021. Clinical decision-making，guidelines，evidence summaries，systematic evaluation，meta-analysis and expert consensuses are included. AGREE Ⅱ，the Document Quality Evaluation Criteria and Evidence Recommendation Level System（2014 edition） of JBI and AMSTAR 2 are used to evaluate the quality and evidence recommendation level of various studies. Results A total of 14 pieces of the literature were included in this study，including 2 clinical decisions，4 guidelines，1 expert consensus and 7 systematic reviews. 4 aspects of the evidence were summarized，including vascular protection，perioperative management，puncture and monitoring. Conclusion This study summarizes the best evidence for prolonging the life length of AVF，and provides a basis for improving the nursing and protecting level of AVF and prolonging its lifetime.

Key words: Hemodialysis, Arteriovenous Fistula, Summary of Evidence, Evidence-Based Nursing

摘要：

目的 检索、评价和总结延长自体动静脉内瘘使用寿命的最佳证据，旨在为医护人员规范管理自体动静脉内瘘提供依据。 方法 系统检索国内外数据库中关于延长自体动静脉内瘘使用寿命的相关文献，检索时限为建库至2021年6月1日，文献类型为临床决策、指南、证据总结、系统评价、Meta分析、专家共识，并提取相关证据。采用2017版临床指南研究与评价系统Ⅱ（the appraisal of guidelines for research and evaluation Ⅱ，AGREE Ⅱ）、澳大利亚乔安娜布里格斯研究所循证卫生保健中心的文献质量评价标准、证据分级系统以及系统评价方法学质量评价工具（a measure tool to assess systematic reviews，AMSTAR 2），对各类研究进行质量评价及证据级别的评定。 结果 共纳入14篇文献，包括临床决策2篇、指南4篇、系统评价7篇、专家共识1篇，总结了血管保护、围手术期管理、穿刺以及监测4个方面的证据。 结论 该研究总结了延长自体动静脉内瘘使用寿命的最佳证据，为临床提高自体动静脉内瘘维护水平，延长其使用寿命提供依据。

关键词: 血液透析, 自体动静脉内瘘, 证据总结, 循征护理学